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Marginal Benefit from Aromatase Inhibitor After Tamoxifen

Breast cancer survivors who are premenopausal, have four or more positive lymph nodes may benefit most

THURSDAY, Nov. 2 (HealthDay News) -- Adding an aromatase inhibitor after five years of tamoxifen therapy has only marginal benefit for most breast cancer survivors, according to estimates from a report published online Oct. 23 in Cancer.

Gary Freedman, M.D., and colleagues from Fox Chase Cancer Center in Philadelphia, estimated which subgroups of breast cancer survivors completing five years of tamoxifen might benefit from additional aromatase inhibitor therapy.

During a median follow-up of 8.25 years, 36 events occurred in 471 women previously treated with breast-conserving surgery, axillary lymph node dissection, radiation and five years of tamoxifen. The investigators estimated that adding an aromatase inhibitor would have had a marginal benefit of 1 to 2 percent.

"Based on our findings, women who are premenopausal at the time of initial therapy and patients who have 4 [or more] positive lymph nodes will have the greatest potential benefit from the addition of extended adjuvant anti-estrogen therapy," the authors write. "The decision needs to be individualized for patients aged 60 years [and older] at the time of initial treatment based on their initial lymph node status and the presence of comorbidities that would reduce their five-year life expectancy."

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